Race and ethnicity play a significant role in determining who is, and who is not, insured. African Americans are twice as likely as whites--and Latina/os three times as likely--to lack health coverage.

Higher uninsured rates exist among these disenfranchised racial and ethnic groups as a consequence of lower rates of employment-based coverage and higher percentages of lower-income families.

Even when insurance and medical treatment is obtained, the quality of care received varies by race or ethnicity.

The first comprehensive study of racial disparities in health care was conducted by the Institute of Medicine, an independent research institution which advises Congress. Reviewing over a hundred studies conducted from 1992 to 2002, the report concluded that the disparities in health care due to race and ethnicity contribute to higher death rates among people of color from cancer, heart disease, diabetes and HIV infections.

For example, according to a study conducted by Medicare, blacks suffering from diabetes are 3.6 times more likely than whites to have their limbs amputated in lieu of receiving more sophisticated treatments.

Evidence overwhelmingly indicates that all things being equal, those who are racially and ethnically disenfranchised will receive a lower quality of health care than their white counterparts.

In short, the present-day health care system in the U.S. is structurally designed in such a way that it brings death to people of color, a reality with historical roots.

The most infamous example is the 40-year-long (1932-1972) Tuskegee experiment, where the U.S. Public Health Service conducted an experiment on 412 poor black sharecroppers in the late stages of syphilis.

They were told by government researchers that they were being treated, when in fact, they were not. The scientific information hoped to be obtained from the experiment was gathered from autopsies of the men. Consequently, they were deliberately left to degenerate under the ravages of tertiary syphilis, whose symptoms included tumors, heart disease, paralysis, blindness, insanity and finally death.

Ironically, as white Americans prosecuted Nazi officials for carrying out medical experiments on Jews during the Nuremberg trials immediately following the Second World War, their own doctors were conducting human experiments on blacks.

More recently, about 1,500 six-month-old black and Hispanic babies in Los Angeles were used as human guinea pigs in June 1990. They were given an experimental measles vaccine developed by Kaiser Permanente called Edmonston Zagreb (E-Z).

The Centers for Disease Control's main purpose in using the E‑Z measles vaccine was to overcome maternal antibodies in babies as young as four months. The parents of these children were never informed that the vaccine, which was used before in two-thirds-world countries with devastating results, was experimental.

When we couple a medical history which devalues the human life of the marginalized, along with a present-day system that continues to perpetuate the attitudes and thinking of this devaluation, we should not be surprised that ethical dilemmas like euthanasia are approached differently by people of color.

As society debates the morality of assisted suicides, people of color cannot help but wonder if this would simply become a new opportunity to victimize the marginalized. If a Latino is being kept alive by a respirator, would doctors encourage the family to "pull the plug" because a white patient might need that respirator?

Seven former and current members of the U.S. Commission on Civil Rights filed legal briefs with the U.S. Supreme Court arguing that the poor, the disabled and those racially and ethnically disenfranchised would be among the first to feel substantial pressure from medical professionals to die if physician-assisted suicide were legal.

Additionally, as medical costs soar, one wonders if insurance companies would find euthanasia more cost effective than paying for aggressive, although expensive, treatment.

The concern among the marginalized is that if assisted suicide becomes a form of medical treatment, it could become a main form of medical treatment for people of color.

Miguel De La Torre, a self-described progressive Baptist, teaches in the religion department at Hope College in Holland, Mich. His column also appears in the Holland Sentinel.